Tranexamic Acid for Percutaneous Nephrolithotomy: Impact on Blood Transfusion and Surgical Outcomes

What is it about?

This content provides a summary of a Cochrane review on the effects of tranexamic acid (TXA) in individuals with kidney stones undergoing percutaneous nephrolithotomy (PCNL). The review includes 10 randomized controlled trials assessing the effect of systemic TXA in PCNL vs placebo or no TXA. The results show that systemic TXA may reduce blood transfusions, major surgical complications, and hospital length of stay, as well as improve the stone-free rate (SFR). However, it may increase adverse events (AEs). The most important concern is the uncertainty regarding the risk of venous thromboembolism with systemic use, even if the risk in absolute terms may be low. The review highlights the need for more representative baseline risks for these outcomes based on a large international observational study. The available evidence suggests that both systemic and topical use of TXA may reduce the risk of transfusion and improve SFRs when performing PCNL, particularly in individuals at higher risk of bleeding. [Some of the content on this page has been created by AI]

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Why is it important?

This research is important because it provides an updated and comprehensive analysis of the effects of tranexamic acid (TXA) in individuals with kidney stones undergoing percutaneous nephrolithotomy (PCNL). The study is based on a systematic review and meta-analysis of 10 randomized controlled trials (RCTs) involving 1,020 patients. The research findings suggest that TXA may reduce the risk of blood transfusions, major surgical complications, and hospital length of stay, as well as improve the stone-free rate (SFR). However, the use of TXA may also increase the risk of adverse events (AEs). Key Takeaways: 1. TXA may reduce the risk of blood transfusions and improve SFRs in PCNL. 2. TXA use may decrease the rates of major and minor surgical complications. 3. TXA may increase the risk of adverse events, particularly when compared to placebo or usual care. 4. The study provides valuable insights for urologists and their patients in making informed decisions about the use of TXA in the setting of PCNL. 5. Further research is needed to better understand the potential increased risk of thromboembolic events (TEEs) associated with TXA use.